High Altitude Living and Diabetes Risk

Living at high elevations might actually lower diabetes risk, and scientists believe they’ve uncovered the reason behind this intriguing phenomenon.

A recent study conducted by the Gladstone Institute in San Francisco delved into how red blood cells function in low-oxygen environments. The research, featured in the journal Cell Metabolism, showed that at higher altitudes, red blood cells start absorbing significant amounts of glucose from the blood, effectively acting like “sugar sponges.” This glucose uptake occurs when oxygen levels are low, which causes these cells to alter their metabolism to deliver oxygen more effectively.

This adaptation leads to a decrease in blood sugar levels, which researchers argue clarifies why individuals residing in elevated regions tend to have a reduced risk of diabetes. A prior study involving over 285,000 adults in the U.S. found that those living between 1,500 to 3,500 meters above sea level had significantly lower diabetes rates compared to those at or below sea level, even after taking factors like diet, age, and race into account.

Lead author Isha Jain, a researcher at Gladstone and a biochemistry professor at the University of California, San Francisco, noted, “Red blood cells represent a previously unappreciated hidden compartment of glucose metabolism. This discovery could open up a whole new way of thinking about blood sugar control.”

Jain’s team previous experiments involved mice to understand how hypoxia—essentially, low oxygen levels—affects glucose levels. They found that mice in altitude conditions rapidly removed sugar from their blood after eating, which is typically linked to a lower risk of diabetes. However, initially, they struggled to pin down where the absorbed sugar went.

“We looked at all the usual suspects: muscle, brain, liver, but we couldn’t explain what was happening to these organs,” said Yolanda Martí Mateos, a postdoctoral fellow in Jain’s lab. The breakthrough came when they utilized a different imaging technique, which revealed that the red blood cells themselves were the key “glucose sink.”

Under hypoxic conditions, these mice produced more red blood cells, and each of these cells absorbed considerably more glucose compared to those in normal oxygen levels.

Moreover, researchers have created a drug named HypoxyStat that mimics the effects of high-altitude living. In clinical trials, this medication completely reversed high blood sugar levels in diabetic mice.

Limitations of the Research

The researchers did acknowledge some limitations in their study. It centered on a particular mouse strain known for its sensitivity to blood sugar. While similar benefits have been observed in humans, testing various mouse strains will be essential for confirming whether the findings can be generalized.

The study exclusively examined young male mice, as age and gender can significantly influence red blood cell production. Thus, more research is required to ascertain if these results are applicable to women and older individuals.

“This is just the beginning,” Jain said, adding that there’s still a lot to learn about how the body adjusts to changes in oxygen levels and how these findings might help treat a variety of health issues.